The Dark Side of Truth in Medicine: Patient Lies and Deception

I have spent 30 years as an operating room Registered Nurse (RN), and during that time, I have witnessed numerous cases where patients, spouses, and even parents have deceived medical professionals. Deception in healthcare is not uncommon, and it often stems from a variety of reasons, ranging from a simple desire to avoid inconvenience to more serious intentions to conceal harmful information.

Patient Deception for Surgical Preparations

One of the most common forms of deception by patients occurs before surgical procedures. Patients frequently lie about not fasting or drinking water after midnight, despite the stringent advice from medical staff. They might think this is a harmless omission, but it can be dangerous. During anesthesia, the patient's airway is unprotected, and a full stomach can result in vomiting. This vomit, if aspirated into the lungs, can lead to severe complications such as aspiration pneumonia or respiratory failure. These risks are very real, and the consequences can be life-threatening.

As a healthcare professional, we are committed to patient safety and must take all necessary precautions. Fasting guidelines are not arbitrary; they are designed to minimize risks and ensure a safer surgical experience. However, when patients choose to ignore these guidelines, the potential for complications increases, and the responsibility of identifying this lies with us as medical professionals.

The Complicity of Spouses and Partners

Not all deception is done by the patient alone. Once, during the pre-operative interview of a patient with her husband standing by, I asked the standard question about previous surgeries. She replied, "No," but later, when her husband was gone, she admitted that she had breast implants. She had kept this information from him. This scenario raises important ethical questions: Is it right for a spouse to withhold information from the patient for personal reasons?

This incident made me wonder how often such deception occurs, especially when partners have different interests or motivations. Spouses are generally expected to be complicit in healthcare decisions, but personal interests can sometimes override this trust. It’s a delicate balance between patient autonomy and the need for complete and truthful information in medical care.

The Consequences of Parents Deception

Another instance of deception happened in 2016 at RML Hospital when a 7-year-old child was admitted with sudden weakness in both lower limbs. Initial diagnosis was Guillain-Barré Syndrome (GBS), but the backstory revealed that the child had been admitted to a private hospital first, where the diagnosis was GBS, and ART (Anti-Retroviral Therapy) was being planned. However, routine HIV tests were conducted and came back positive. This is a critical point: private hospitals often refer cases of HIV-positive children to government hospitals for specialized care.

The parents of the child were initially asked about their HIV status, but they refused to acknowledge it. Despite multiple attempts to uncover the truth, the parents consistently denied knowing the child's HIV status. Even when asked to show test reports from the private hospital, they provided inconsistent and vague answers. It became evident that they were lying about their HIV status, which could have significant implications for their own health and that of their child.

This case highlights the importance of thorough investigation and healthcare professionals' vigilance. Deception can have severe consequences, not only for the patient but also for the involved family members. The medical team was faced with the ethical dilemma of confronting the parents while respecting patient confidentiality and providing the child with the necessary treatment.

Conclusion and Reflection

Deception is a complex issue in healthcare, and it can arise from various factors, including personal motivations, misinformation, and complicity. As medical professionals, we must be aware of the potential for deception and strive to maintain open and honest communication with our patients. Our primary goal is to provide the best possible care and ensure the health and safety of our patients.

It is crucial to educate patients and their families about the importance of truthfulness in medical settings. Health professionals must foster an environment where patients feel safe to share information, even if it may be uncomfortable or inconvenient. Building trust and transparency can help prevent future incidents of deception, ultimately leading to better patient outcomes.

Deception in healthcare is a serious concern, and addressing it requires a multidisciplinary approach involving medical professionals, ethicists, and healthcare administrators. By working together, we can create a culture where truthfulness is valued and encouraged, ensuring that both patients and healthcare providers can trust each other.